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[Neuro-Behcet disease mimicking a thalamic tumor]
J Yoshimura1, M Toyama, Y Sekihara
1Department of Neurosurgery, Nagaoka Red Cross Hospital.
No Shinkei Geka. Neurological Surgery
|July 17, 2001
Summary
Neuro-Behcet disease can mimic brain tumors, presenting as expanding thalamo-lenticular lesions. Stereotactic biopsy aids in differential diagnosis for these rare neurological cases.
Area of Science:
- Neurology
- Neuroimmunology
- Radiology
Background:
- Neuro-Behcet disease is a rare systemic vasculitis affecting the central nervous system.
- It can manifest with diverse neurological symptoms and imaging findings.
- Differentiating neuro-Behcet disease from other intracranial pathologies is clinically challenging.
Observation:
- A 41-year-old female presented with cognitive decline and hemiparesis.
- She had a history of recurrent oral/genital ulcers and erythema nodosum.
- Cerebrospinal fluid analysis revealed pleocytosis.
- Neuroimaging demonstrated a thalamo-lenticular expanding lesion with mass effect.
Findings:
- CT and MRI revealed a hypodense lesion in the left lenticulothalamic region with central enhancement.
- MRI showed high T2 signal intensity and low T1 signal with contrast enhancement.
- EEG, SPECT, and angiography were unremarkable.
- Brain biopsy excluded malignancy but lacked specific diagnostic features.
Implications:
- Neuro-Behcet disease can present radiologically mimicking a cerebral tumor.
- Stereotactic biopsy is a valuable tool for excluding brain tumors in suspected neuro-Behcet disease.
- Early diagnosis and appropriate management, such as steroid therapy, can lead to clinical improvement.
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